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Skeletal muscle loss in the postoperative acute phase after esophageal cancer surgery as a new prognostic factor.
- Source :
-
World journal of surgical oncology [World J Surg Oncol] 2020 Jun 26; Vol. 18 (1), pp. 143. Date of Electronic Publication: 2020 Jun 26. - Publication Year :
- 2020
-
Abstract
- Background: The postoperative survival rate of patients with esophageal squamous cell carcinoma (ESCC) remains poor compared with other gastrointestinal cancers. We hypothesized that skeletal muscle loss in the postoperative acute phase might be a new predictor for long-term prognosis after highly invasive surgery such as ESCC surgery.<br />Methods: The following items were retrospectively investigated. First, whether skeletal muscle loss occurred in the postoperative acute phase of ESCC was verified. Second, the preoperative and intraoperative factors involved in skeletal muscle loss in the postoperative acute phase of ESCC were investigated. Then, whether skeletal muscle loss in the postoperative acute phase affected long-term prognosis was examined. The medical records of consecutive patients who underwent radical esophagectomy for ESCC between January 2010 and February 2015 were retrospectively reviewed; 72 cases were eligible for this study. The total psoas major muscle mass index (TPI) at the level of the third lumbar vertebra (L3) was measured using computed tomography (CT) before surgery and 3 days after surgery. The long-term prognosis was estimated by the Kaplan-Meier method and the multivariate logistic regression model.<br />Results: There was already a significant reduction of TPI in the acute phase up to POD 3 after ESCC surgery in comparison with the preoperative baseline TPI (P < 0.001). The TPI reduction rate was significantly milder in cases with less blood loss during surgery and in cases that underwent thoracoscopic esophagectomy than in cases that underwent open esophagectomy. The 3-year overall survival rate was significantly different between the TPI reduction rate severe group and the TPI reduction rate mild group.<br />Conclusion: Skeletal muscle loss occurred even in the postoperative acute phase. Furthermore, it is very significant that skeletal muscle loss in the postoperative acute phase of ESCC surgery is involved in the long-term prognosis.
- Subjects :
- Acute-Phase Reaction
Adult
Aged
Aged, 80 and over
Esophageal Neoplasms pathology
Esophageal Squamous Cell Carcinoma pathology
Female
Humans
Male
Middle Aged
Postoperative Complications etiology
Prognosis
Retrospective Studies
Risk Factors
Sarcopenia etiology
Survival Rate
Esophageal Neoplasms surgery
Esophageal Squamous Cell Carcinoma surgery
Esophagectomy adverse effects
Muscle, Skeletal pathology
Postoperative Complications pathology
Sarcopenia pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1477-7819
- Volume :
- 18
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- World journal of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 32591002
- Full Text :
- https://doi.org/10.1186/s12957-020-01908-6